A prospective study of the responsiveness of the original and the short form Berg Balance Scale in people with stroke.

OBJECTIVE: The study aim was to examine the responsiveness of the Berg Balance Scale (BBS) and that of its short form (SFBBS) at both the individual person level and the group level. DESIGN: A repeated-measurements design. SETTING: Hospital and home setting. PARTICIPANTS: Patients with stroke. RESULTS: Totals of 226, 202, and 168 patients with stroke were assessed with the BBS at 14, 30, and 90 days after stroke, respectively. The SFBBS data were extracted from the patients' responses on the BBS. At the group level, the BBS and the SFBBS had sufficient and similar responsiveness. For the Rasch scores, the effect sizes of the three change scores for the BBS and the SFBBS, respectively, had similar ranges between 0.38 and 0.88 and between 0.39 and 0.85, respectively. The standardized response means of the three change scores for the BBS and the SFBBS ranged from 0.74 to 1.33 and from 0.72 to 1.13, respectively. At the individual person level, the BBS detected significant balance improvement in about twice as many patients as the SFBBS detected. CONCLUSION: The responsiveness of the BBS at the individual person level was better than that of the SFBBS in patients with stroke. The BBS is recommended as an outcome measure to better detect changes in individual patients.

Is the long form of the Fugl-Meyer motor scale more responsive than the short form in patients with stroke?

OBJECTIVE: To compare the responsiveness of the Rasch-calibrated 37-item Fugl-Meyer motor Scale with that of the 12-item Fugl-Meyer motor scale at both an individual and a group level. DESIGN: Repeated-measurements design. SETTING: Medical center. PARTICIPANTS: Patients (N=301) 14 days after stroke. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: 50-item Fugl-Meyer motor scale, 37-item Fugl-Meyer motor scale, and 12-item Fugl-Meyer motor scale. RESULTS: The patients were assessed with the original 50-item Fugl-Meyer motor scale 4 times, at 14, 30, 90, and 180 days after stroke onset. The patients' responses were used for estimating the Rasch scores of the 37-item Fugl-Meyer motor scale and 12-item Fugl-Meyer motor scale. The effect size, standardized response mean, and paired t test were used to compare the group-based responsiveness of the 3 forms (50-item Fugl-Meyer motor scale, 37-item Fugl-Meyer motor scale, 12-item Fugl-Meyer motor scale). Individual-level responsiveness was compared based on the significance of change between the 37-item Fugl-Meyer motor scale and 12-item Fugl-Meyer motor scale. Because up to 13 items of the 50-item Fugl-Meyer motor scale did not meet the Rasch model's assumptions, the significance of change of the 50-item Fugl-Meyer motor scale was not calculated. At the group level, the FM-37 and FM-12 Fugl-Meyer motor scale had sufficient and similar responsiveness. At the individual level, the FM-37 Fugl-Meyer motor scale detected more patients with significant improvement than the FM-12 Fugl-Meyer motor scale. The SC values and category distribution of the FM-37 Fugl-Meyer motor scale were significantly better than those of the FM-12 Fugl-Meyer motor scale (P<.001). CONCLUSIONS: Although the group-level responsiveness of the 12-item Fugl-Meyer motor scale was sufficient and very similar to that of the 37-item Fugl-Meyer motor scale, the 37-item Fugl-Meyer motor scale had better individual-level responsiveness. The 37-item Fugl-Meyer motor scale is suggested as an outcome measure for both clinicians and researchers.